Yale Cancer Center doctor leads clinical trial

Published 7:17 pm, Tuesday, June 28, 2016

NEW HAVEN >> A drug that uses the body’s immune system to fight advanced bladder cancer has been approved by the Food and Drug Administration.

The FDA has granted accelerated approval to atezolizumab, marketed as Tecentriq by Genentech, the first new treatment approved for the most common form of bladder cancer in more than 30 years,

“We’ve seen some fairly dramatic responses in some patients,” said Dr. Daniel Petrylak, an oncologist and professor of medical oncology at the Yale Cancer Center, who was a lead investigator in first- and second-phase clinical trials of the drug. He said at least one patient has been cancer-free for three years, while half have survived nine months or more.

“Bladder cancer is nationally the fifth leading cause of cancer incidence,” Petrylak said, and the fourth most common cause in Connecticut. It accounts for 77,000 cases and 16,000 deaths annually in the United States, he said.

Chemotherapy is only fully effective in about one-third of patients with the most advanced form of the disease, called metastatic urothelial carcinoma, and will partially shrink the tumor in another third, Petrylak said, five-year survival rates are only about 5 percent to 10 percent. The urothelium is the innermost lining of the bladder. The cancer can spread into the liver, bones and lymph nodes.

“Basically, the bladder cancer cells can make … chemicals that shut the immune system off,” Petrylak said. “This drug interferes with that process. It takes the brakes off of the immune system.”

The drug works by blocking a protein called PD-L1, which is created by the cancer cells and which stops the cancer-fighting effect of the immune system’s T-cells. Chemotherapy is not as specific to the cancer cells and kills off healthy cells as well. Tecentriq can be given to patients whose disease is not controlled by chemotherapy, either before or after surgery.

“Even though bladder cancer is the fifth most commonly diagnosed cancer in the United States, it hasn’t received the same attention within the cancer community as other common cancers,” said Diane Zipursky Quale, president and co-founder of the Bladder Cancer Advocacy Network, in a press release.

Studies are underway to test whether Tecentriq could be used to treat kidney, liver, prostate and lung cancer, Petrylak said.

This story was edited to add that Petrylak was a lead investigator in phase two trials of Tecentriq as well as phase one trials.